Influence of operator skill level on the clinical outcome of non-surgical periodontal treatment: a retrospective study

Original Article



The aim of this study is to evaluate the effect of operators experience and skill on treatment results of initial non-surgical periodontal therapy.

Materials and methods

Initial periodontal treatment was carried out by either second-year periodontal residents (PR) or last year dental students (DS). From the treatment records of patients in each group, plaque and bleeding indices, and pocket depth (PD) at baseline and at re-evaluation were collected retrospectively on each tooth at six locations. Data were separated according to tooth type, area, and probing depth categories, sub-grouped to 1–3, 4–5, and ≥ 6 mm.


Fifty and 49 records of DS and PR patients, accordingly, were analyzed. Initial periodontal treatment improved patient compliance in both groups and reduced signs of inflammation with significantly superior results in the PR group. Significant change in percentage of pockets was recorded in each category. The increase in percentage of sites with PD 1–3 mm and decrease in percentage of PD ≥ 6 mm pockets was significantly (p ≤ 0.001) superior in patients treated by PR. Percentage of 4–5 mm pockets was significantly reduced in both groups (p ≤ 0.01), with a significantly greater reduction in the mandibular molar and anterior teeth in the PR group.


Experience and skill significantly affect the outcome of non-surgical periodontal therapy, with more positive improvement in patient compliance and clinical parameters when performed by a more qualified operator.

Clinical relevance

Improvement of operator skills may decrease the number of residual pockets and increase patient compliance following non-surgical periodontal treatment.


Initial therapy Non-surgical therapy Operator experience Scaling and root planing Periodontal re-evaluation 



The authors are grateful to Dr. Ronit Bar-Ness Greenstein (The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel) for helpful discussion and significant help in writing the manuscript.


The work was supported by the Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.

Compliance with ethical standards

Conflict of interests

Author A: Avital Kozlovsky declares that she has no conflict of interests.

Author B: Alex Rapaport declares that he has no conflict of interests.

Author C: Zvi Artzi declares that he has no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional ethical committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental MedicineTel Aviv UniversityTel AvivIsrael
  2. 2.Private practisePetach-TiquaIsrael

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